Chronic Hepatitis C: Retreatment After First-Line Antiviral Therapy Did Not Achieve SVR12
Clinical Population
Adults (age ≥18 years) with chronic hepatitis C infection of any genotype, without cirrhosis or with compensated cirrhosis (Child-Pugh A). Persons living with HIV are included. This protocol applies to patients who have already completed a course of first-line HCV therapy.
Prior Treatment Failure
First-line treatment with regimens such as glecaprevir/pibrentasvir or sofosbuvir/velpatasvir was completed, but the primary treatment goal — SVR12 (undetectable HCV RNA 12 weeks after end of therapy) — was not achieved. This protocol defines the recommended next step after that failure.
Retreatment Approach (partial overview)
Retreatment involves a sofosbuvir-based direct-acting antiviral combination. For certain genotype 3 cases with compensated cirrhosis, an additional agent may be incorporated when there are no contraindications. Full regimen selection, genotype-specific guidance, and eligibility criteria are in the complete protocol.
Treatment Goal
SVR12 — sustained virologic response confirmed by undetectable HCV RNA at 12 weeks after completing retreatment.
References
DOI: 10.1093/cid/ciad319
- Generally, persons who have experienced treatment failure with a sofosbuvir-based regimen should be retreated with 12 weeks of sofosbuvir/velpatasvir/voxilaprevir.
- For genotype 3 infection with compensated cirrhosis, add weight-based ribavirin if there are no contraindications.
- Adults with chronic HCV infection, including persons living with HIV:
- Without cirrhosis or with compensated cirrhosis (Child-Pugh A) as determined by:
- SVR12, sustained virologic response 12 weeks after completion of therapy.
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